The idea that the Pauling therapy might loosen plaque is a worry I had long ago, and brings up an old memory. I have read Dr. Rath's theory that the plaques (atheromas) dissolve at the molecular level, and that Rath believes there is little or no risk. From our now more than a decade of experience, I cannot recall a single report where such a thing was even suspected. But back to the memory.
In the beginning, we had little to go on besides our trust in Linus Pauling. So when a relative had a heart attack and went in for by-pass surgery - we kept our mouths shut. Well, a piece of plaque did break off during the surgery and our relative died on the table.
And I strongly suggest that your read Dr. Levy's STOP AMERICA'S #1 KILLER (livonbooks.com). It explains that old plaques develop into something like tissues - or callouses - and that they even grow a blood supply, i.e., capillaries, etc. In fact, after reading this book written by a cardiologist, I really have no idea why Pauling's therapy seems to work so fast in the most critically ill. (The reason is probably as Levy speculates, the lysines's effect is like arginines and based on creation of NO which expands the arteries, while the other slower effects are taking place.)
Owen R. Fonorow, Orthomolecular Naturopath